Michael Brendan Dougherty recently made the very thoughtful point that, as we make our way through this pandemic, those who are most worried about the economy and those who are most worried about health ought to listen respectfully to each other. He was right, and I wanted to elaborate.
The whole debate rests on the assumption that there is an inevitable trade off between health interests and economic interests. That assumption is mostly false, and the officials who actually have to make decisions, and their advisors, understand it is false.
When the administration’s coronavirus task force has a meeting, the economists and public-health officials are not sitting at opposite sides of the table glowering at each other. Both groups acknowledge the co-dependence of the equities that are stake.
The economists are not saying that we should allow the virus to rage on unchecked. Economics may be a bloodless discipline, but the people in it care about human life too; and even if they didn’t, they know that uncontrolled epidemics aren’t exactly a recipe for economic growth.
And medical authorities are acutely aware that economic stagnation isn’t good for public health. I have a decade’s personal experience dealing with those authorities on the danger of a pandemic; they always worry about the economic damage.
In fact, health officials know that severe quarantines and restrictions are at best a mixed bag, even looking only at the medical consequences. As one example, public health authorities often resist closing elementary schools because 1) we need health care workers to fight an epidemic, 2) quite a lot of health care workers have children, and 3) when young children are out of school, their parents have greater responsibility to care for them, which means 4) the practical result of closing schools is that, at least in the short term, health-care systems lose manpower.
If the immediate purpose of severe restrictions is to relieve the stress on the health system, it’s not surprising that medical authorities are reluctant to take a step which, whatever else it does, is likely in at least one respect to increase the stress on the health care system.
Moreover, health officials are well aware that if restrictions are too comprehensive, or last too long, people will simply disobey them. That’s why, in places where severe restrictions are in place, health authorities as well political officials are practically begging the public to comply.
They know the United States isn’t China. We’re not going to weld people into their homes. When the public becomes too weary of comprehensive social-distancing measures, the measures can produce the worst of both worlds: they are not obeyed sufficiently to slow the spread of the disease, but their presence continues to stifle the economy.
Finally, everyone is in agreement that the core epidemiological responses are and will remain necessary: vigorous and more effective testing, urgent efforts to expand hospital capacity and find better therapeutics, isolation of the sick and quarantine of those exposed, social distancing for high-risk people, and common sense hygienic practices that everybody ought to practice even in a normal flu season and that are the single most effective way to interrupt the vectors of the disease.
Larry Kudlow and Deborah Birx both have the same message for you: wash your hands, damn it. And keep washing them, not only while the disease is epidemic but even after it has become endemic, which it will be until we get a vaccine.
I think as time goes on we’ll approach the disease less as a national epidemic than as a rolling series of local epidemics. The federal government will continue developing therapeutics, buying supplies, and ensuring the public and health authorities have the best available information, while governors and mayors adjust the degree of social distancing in their jurisdictions as they play whack a mole with the virus.
Meanwhile, Michael’s column sounded the right note. Nobody knows for certain what to do, but everybody is trying to achieve the same things. There will be vigorous disagreements, but the only enemy here is COVID-19.
Here’s a reason for optimism. The whole life-science apparatus, public and private, of virtually the entire world, and much of its entrepreneurial and innovative energy, is now focused on a single problem: how do we kill this stinking virus?
These are hard times, but we’re all in the same fight. God willing, we’re going to win.